Craniocerebral injury is the second most common trauma in the incidence of trauma after the extremities. The cause of injury is the direct or indirect action of violence on the head: common in traffic accidents, work injuries, fall of foot, etc.; wartime is seen in the explosion of high-pressure gas wave impact, fortifications or building collapse and firearms, sharps injuries, etc.. The injury is divided into closed and open two. The symptoms caused by the injury are diverse, mainly in cognition (memory, attention, orientation, understanding and judgment), behavior, emotion, speech, perception, movement and other aspects.
Closed craniosynostosis may have the following outcomes depending on the severity.
1, death.
2, vegetative state: unconscious, with arousal, may have eye opening, sucking, yawning with local motor response.
3. severe disability: conscious but with severe impairment in cognition, speech and somatic movement, with the patient requiring 24-hour care.
4.Moderate disability: independent in daily life, family and social activities. However, there is still disability. Patients show memory or personality changes, mild hemiparesis, swallowing difficulties, ataxia, secondary epilepsy or cranial nerve palsy.
5. Good recovery: Patients are able to re-enter normal social life and return to work, but may have mild sequelae.
The goal of rehabilitation is to maximize outcome 4 for patients with severe brain injury and outcome 5 for patients with mild brain injury. Traumatic brain injury is mostly in young people, and years of rehabilitation experience tells us that young traumatic brain injury patients have more value for rehabilitation, and with regular and effective early rehabilitation, there are often some unexpected effects.
Treatment of common functional disorders
1.Treatment in the acute stage: necessary medication and surgical treatment, strengthening nutrition; passive activities to prevent joint stiffness; prevention of pressure sores and deep vein thrombosis; correction of abnormal posture using reflex inhibition mode; hyperbaric oxygen therapy, etc.
2, rehabilitation treatment of cognitive disorders: computers have been widely used abroad for cognitive rehabilitation, but they are not yet popular in China. The following methods are commonly used at present.
(1) Training of attention and concentration: guessing games, deletion of homework, sense of time, homework therapy: knitting, woodworking, puzzle practice, etc.
(2) Training of memory: visual memory, story making method, occupational therapy: woodworking, clay work, inlay, arrow throwing, etc.
The following methods should be used in daily life.
1.Establishing a constant daily activity routine for the patient to repeat and practice constantly.
2.Patiently and quietly ask questions and give orders to the patient.
3, from simple to complex exercises, the entire exercise is broken down into small parts, first a small part of a small part of training, and then gradually joint after success.
4.Use multiple sensory inputs such as visual, auditory, tactile, olfactory and motor to cooperate with the training.
5, each training should be short, and reward should be given promptly and frequently when the memory is correct.
6.Let the patient distinguish the key points and remember the most necessary things first, not to remember some irrelevant trivial things.
Rehabilitation of behavioral disorders
For episodic loss of control and frontal lobe aggression, medication and positive punishment method behavioral treatment are available. For negative conduct disorder, behavioral therapy such as negative punishment method, molding method, and token method are used. Occupational therapy is also available to eliminate aggressive affect.
Rehabilitation of speech disorders and motor disorders
For patients with speech disorders, a good speech environment should be created and abnormal articulation should be corrected in time. Oral, pharyngeal, lip, tongue and spirometry training are used according to the manifestation of their aphasia or dysarthria.
Their motor disorders can be improved by Bobath technique, Rood technique, Brunnstrom technique, PNF technique, and motor-in-learning method.